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Organization
DENTAL DEPOT OF SURPRISE, PLLC
Active
Organization
DENTAL DEPOT OF SURPRISE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN A ASHMORE (OWNER / CEO)
(405) 945-8941
Entity
Organization
Contact information
Practice address
13828 W. GREENWAY RD., SURPRISE, AZ 85374
(623) 562-9123
(623) 259-0153
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(623) 562-9123
(623) 259-0153
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/03/2020
Last updated
06/13/2025
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